New data presented at the American Society of Hematology (ASH) Annual Meeting and Exposition reveals how chemotherapy and immunotherapy may drive the emergence of CD-19–negative, myeloid-like subclones in pediatric B-cell acute lymphoblastic leukemia (B-ALL). Mr. Ryan Quigley sits down with Dr. Kathrin Bernt, Dr. Fatemah Alikarami, and Mr. Rushabh Mehta to discuss how their findings could impact minimal residual disease detection, therapy resistance, and future risk stratification strategies. Dr. Bernt is a pediatric oncologist and an Associate Professor of Pediatrics at the Children’s Hospital of Philadelphia. Dr. Alikarami is a Research Associate Scientist at the Children’s Hospital of Philadelphia. Mr. Mehta is a PhD candidate in cell and molecular biology at the University of Pennsylvania.